We help people deal with bankruptcy every day, and while we’ve pretty much seen and heard it all, each person’s story is different. A common theme, though, is folks who have found themselves in financial peril because of medical debt.

Many people assume that because they have health insurance they don’t have to worry about going into debt. The Kaiser Family Foundation studies healthcare and provides information about things like Medicaid, health reform, and insurance. In a 2015 study, they found that 52 million adults struggled to pay medical bills. At least a million of them declared bankruptcy.

How does this happen?

Josh was an otherwise healthy young man, but a high fever and sharp pains had him worried. He asked a roommate to take him to the emergency room, where doctors quickly discovered his issue: appendicitis.

His emergency room doctors were alarmed, saying that he was in immediate danger. They had to operate right away. So they did, and Josh went home the next day.

Weeks later, Josh got his bill. The total cost was $41,212, but after his insurance covered their end, he was faced with a bill of just over $28,000.

The hospital closest to Josh was out-of-network.

Frank was facing crippling back pain. He finally went to see a specialist, who sent him to the hospital. At the hospital, doctors ordered an MRI, which showed a horribly herniated disk in his spine. If they didn’t operate right away, Frank could be paralyzed.

Frank’s bill came to a little over $650,000 because his insurance company said his procedure didn’t qualify as an “emergency.”

Closer to home, Chris was trying to enjoy a family vacation in Rappahannock when his “heartburn” turned to chest pains and tingling in his arms. His family took him to a hospital in Rappahannock – which happened to be in his insurance network – and the doctors told him that he was having a heart attack. They were going to rush him to the best facility in the area for immediate care. That happened to be in Mechanicsville.

Chris got a bill for a $57,138 helicopter ride.

Most of these stories had a successful resolution, but they required navigating arcane insurance language, negotiating complex billing issues, and in Frank’s case, appealing to his governor.

What can you do if you face an impossible bill?

As in all debt situations, don’t ignore your bills. Doctors and hospitals are compassionate people and places, but the folks who handle their billing aren’t shy about sending accounts to collection agencies. A bad mark for medical debt is no different than defaulting on a loan or being behind on your credit cards, and impacts your credit rating.

When you open that bill, make certain that it’s actually a bill. Your doctor may send you something looking like an invoice that’s actually just a statement explaining what was covered by your insurance. Your insurance company will likely send you something called an “explanation of benefits.” This tells you how they decided to pay what they did, how much, and maybe what you owe.

You should also be prepared to argue and negotiate. Your insurance company may be in the wrong when it comes to denying coverage. They may be improperly billing you for something. Get to the nuts & bolts of your policy. You may have been charged $100 for an aspirin. Tell your insurance company that $100 is too much to pay for an aspirin, and you may be able to reduce that cost.

The folks looking for your money also like to be paid. Often, a billing agency will offer a discount to simply close out your account. They may reduce your costs with a promise of consistent monthly payments. You may be able to negotiate a comfortable payment plan that satisfies your debt but is still manageable.

When you ignore your debts, or make rash decisions like payday loans or second mortgages, you don’t really solve your problem. You just string it along.

Let us help you avoid doing that.